She Was Pregnant and Addicted to Fentanyl: How Keeping Her Baby Saved Them Both.
Eight months pregnant and in severe pain, Stephanie Rosell visited the medical facility after an infection began spreading up her legs. Without a job or home, cut off from her relatives, she lived in a shed she had assembled in a companion's property. She was also hooked on fentanyl.
As doctors treated her infection, she grew increasingly fearful. Withdrawal was setting in. She slumped forward and became sick.
Stephanie ultimately gave in. “I have to get out of here. I have to go home and take a hit.”
She had used fentanyl before coming to the ER and had sufficient opportunity to get treated before she needed to go home to use once more. She thought she still had a month remaining to find a way to become sober and deliver her child.
The nurse had other ideas. She told Stephanie she was staying put.
“Yes, I am,” Stephanie said.
But the doctors would not let her go: the condition in her limbs was serious, but medical staff detected she also had an leakage of amniotic fluid. The nurse, a caregiver named Izzie, warned her: if she departed, she and her baby would be at risk of death.
The nurse convinced the doctor to give Stephanie measured quantities of fentanyl at regular intervals, knowing that symptoms could threaten her and the baby. After delivery Stephanie would be switched to methadone, a medication that eases withdrawal and is often prescribed in rehabilitation.
After five days, on the 12th of November, Stephanie had a baby girl weighing a small weight – early, small but alive.
When the caregiver questioned if she wanted to cuddle her newborn, Stephanie said “no.” She was numb. Her pain relief did not work, her previous intake of fentanyl had been provided four hours before delivery.
She felt ill. Not ready for motherhood. Undeserving.
Stephanie had attempted sobriety several times during pregnancy, and felt horrible each time she was unsuccessful. She felt hopeless, berating herself for not being able to overcome the challenge. An OBGYN told her to “simply” stop using. Even her dealer declined to supply to her when she became clearly expecting.
“However, I failed,” she said. “I needed help.”
The common assumption that her bond with her newborn would make her recover only led to increased guilt and self-abuse, a cause for her to relapse. Yet she could not easily command her addiction away, any more than she could overcome a chronic disease.
The baby was taken to the neonatal intensive care unit. When Stephanie finally saw her her, she was attached to tubes and leads, so tiny she thought she would harm her. Holding her for the first time, she felt empty. “I looked at her and was like, ‘What is our future?’” She remained uncertain she wanted to be her mother.
After two days she decided to name her baby the same as her nurse, after the attendant who showed compassion to her.
Hospital staff told her about a care center, a innovative treatment home where mothers and their drug-exposed newborns are cared for jointly, not apart.
In much of the US, where a baby is found to have infant withdrawal condition regularly, infants are still quickly moved to hospitals and medicated while their mothers face custody evaluations. But a developing system of centers like this facility is showing an important truth: when families are kept intact, results get better, custody cases decrease and future expenses reduce.
It took Stephanie a period to find strength to call, but she ultimately reached out. After confirming she would be a good fit for the program, a couple of employees came to bring her to the facility.
She left the medical center still in detox, scared and uncertain about what would come next.
At the care center, Stephanie still was concerned that authorities would come take Izzie – even though she was not sure she wanted to keep her. The anxiety remained: that at any time, someone could walk in and separate them.
For the initial fortnight, Stephanie kept to herself. “I avoided interaction,” she said. “I didn’t have a lot of trust at that point.”
Homelessness, she said, was about enduring. Substances came first; trust came last.
Stephanie had a single companion, but even that relationship was delicate. The people she loved always found ways to hurt her. She lacked the ability to value herself, much less anyone else.
Every day, staff from the facility took her to a treatment center, administered in pill form. Gradually, she was starting to get clean.
She spent every minute outside treatment with Izzie, and could see that her baby was getting the specialized care she needed. Her daughter struggled with eating at first, with intolerance to some formulas and severe digestive problems. She needed nutritional guidance. She also had sensory challenges and required an specialist – all frequent conditions for babies affected by withdrawal.
Seeing that even a young person understands the need for care, then I found the strength. I would become a mother.
During a pre-holiday visit, Stephanie sat in the visitation area, where those still using can come for guided meetings with their babies. A support specialist, a recovery coach, visited with her own family in tow to bring treats. They all assembled beside Stephanie, who was seated on the ground holding Izzie.
The kids looked amazed in admiration of the tiny infant in Stephanie’s arms. “They were innocent,” Stephanie said. “They didn’t care that I had used drugs with her. They focused only on the baby.”
She holds a picture of the moment. She is clad in casual attire, a beanie with a bobble on her head, seated on the ground with the entryway at her back. She is lean. Her posture is humble so you cannot see her face. She is holding Izzie up on her leg for the children to see and they are standing close, showing interest to the baby.
One child, eight, asked the moms: “What about the fathers?” The parents responded that the dads were busy, engaged elsewhere, that they would be there if possible.
“When I have kids,” Jacob said, “I plan to be a great parent. I will teach them about love.”
Stephanie and the specialist exchanged glances. “I just lost it and fell apart,” Stephanie said. “If this little kid could see that newborns require care, then I was able. I would become a mother.”
Approaches for managing infants affected by substances have existed for decades.
The evaluation method was created in 1975|
